Healthcare Provider Details

I. General information

NPI: 1598516619
Provider Name (Legal Business Name): MASSA DOPOH LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2417 LANCASTER AVE STE 111
WILMINGTON DE
19805-3736
US

IV. Provider business mailing address

2417 LANCASTER AVE STE 111
WILMINGTON DE
19805-3736
US

V. Phone/Fax

Practice location:
  • Phone: 302-446-4310
  • Fax:
Mailing address:
  • Phone: 302-446-4310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: